<div class="check">

    <form class="form-horizontal" action="<?= lang_url('excursions/confirmation') ?>" method="get" id="doreservation">

        <?php
            $R_STATUS = WAITNG_PAYMENT;

            $mytag_name = array();
            foreach ($reservation->tags as $tag)
                $mytag_name[] = $tag->name;


            if (!empty($mytag_name))
                $mytag_name = implode(', ', $mytag_name);
            else
                $mytag_name = "";


            $pickup_loc = explode(',', $reservation->pickup_location);
        ?>

        <input class="hidden" type="text" name="excursion_id" id="exc_id" value="<?= $_GET['exc_id'] ?>">
        <input class="hidden" type="text" name="date" value="<?= $_GET['check_in'] ?>">
        <input class="hidden" type="text" name="adl" value="<?= $_GET['nr_adults'] ?>">
        <input class="hidden" type="text" name="chd" value="<?= $_GET['nr_childrens'] ?>">
        <input class="hidden" type="text" name="reservation_status" value="<?= $R_STATUS ?>">
        <input class="hidden" type="text" name="s_b_i" value="cipa-booking.com">

        <div id="payment_insurance">

            <div class="payment">
                <?php
                    $this->load->view('parts/totalExcursions', array(
                        'service_total' => $reservation->form->service_price,
                        'total' => $reservation->form->total_price,
                        'service_name' => $reservation->name
                    ))
                ?>
            </div>

        </div>

        <div class="sec">

            <div id="summary" class="secp clearfix">

                <img src="<?= HOST_URL_HOTELS . $reservation->photo_path . '/thumb_182x123/' . $reservation->photo_name; ?>">


                <ul>
                    <li class="section"><h4><?= $reservation->name ?></h4></li>
                    <li>Category: <span><div class="tag-icon"></div><?= $mytag_name ?></span></li>
                    <li>Guides: <span><?= implode(', ', explode(',', $reservation->guides)) ?></span></li>
                    <li><?= lang('dtl.num_of_persons'); ?>: <span><?= lang('dtl.adults'); ?>: <?= $_GET['nr_adults'] ?>, <?= lang('dtl.children'); ?>: <?= $_GET['nr_childrens'] ?></span></li>
                    <li>Departure day: <span> <?= $_GET['check_in'] ?>, <?= date('l', strtotime($_GET['check_in'])) ?></span></li>

                </ul>

            </div>
            <!-- /summary-->

            <div id="passenger" class="secp clearfix">

                <h4><?= lang('c.info_reservation_holder'); ?></h4>

                <div class="half pull-left">
                    <div class="inner_prices">

                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('gender'); ?>:*</label>
                            <div class="controls">
                                <select placeholder="<?= lang('gender'); ?>" name="sex" id="sex" required>
                                    <option value=""><?= lang('gender'); ?></option>
                                    <option value="M" selected="selected"><?= lang('male'); ?></option>
                                    <option value="Z"><?= lang('female'); ?></option>
                                </select>
                            </div>

                        </div>
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('name'); ?>:*</label>
                            <div class="controls">
                                <input type="text" placeholder="<?= lang('name'); ?>" name="name" id="name" required value="Ivan">
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('date_of_birth'); ?>:*</label>
                            <div class="controls">
                                <input type="text" placeholder="<?= lang('date_of_birth'); ?>" name="birth_date" id="birth_date" required value="01.08.1982">
                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('mobile_phone'); ?>:*</label>
                            <div class="controls">
                                <input type="text" placeholder="<?= lang('mobile_phone'); ?>" name="phone" id="phone" required value="067 613 079">

                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('city'); ?>:*</label>
                            <div class="controls">
                                <input type="text" placeholder="<?= lang('city'); ?>" name="city" id="city" required value="Bar">
                            </div>
                        </div>
                    </div>
                </div>

                <div class="half pull-left">
                    <div class="inner_prices">
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('email'); ?>:*</label>
                            <div class="controls">
                                <input type="email" placeholder="<?= lang('email'); ?>" name="email" id="email" required value="ikukic@yahoo.com">

                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('surname'); ?>:*</label>
                            <div class="controls">
                                <input type="text" placeholder="<?= lang('surname'); ?>" name="surname" id="surname" required value="Kukić">

                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('address'); ?>:*</label>
                            <div class="controls">
                                <input type="text" placeholder="<?= lang('address'); ?>" name="address" id="address" required value="Jovana Tomaševića 32">

                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('zip_code'); ?>:*</label>
                            <div class="controls">
                                <input type="text" placeholder="<?= lang('zip_code'); ?>" name="zip" id="zip" required value="85000">

                            </div>
                        </div>
                        <div class="control-group">
                            <label class="control-label" for="service"><?= lang('country'); ?>:*</label>
                            <div class="controls">
                                <select required="" id="country" name="country" placeholder="Country">
                                    <option value="">Country</option>
                                    <option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antarctica">Antarctica</option><option value="Antigua and Barbuda">Antigua and Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="Bahamas">Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Brazil">Brazil</option><option value="British Indian Ocean">British Indian Ocean</option><option value="Brunei">Brunei</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="China">China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo, Democratic Republic of the">Congo, Democratic Republic of the</option><option value="Congo, Republic of the">Congo, Republic of the</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Croatia">Croatia</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="East Timor">East Timor</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Guiana">French Guiana</option><option value="French Polynesia">French Polynesia</option><option value="Gabon">Gabon</option><option value="Gambia">Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guatemala">Guatemala</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Ireland">Ireland</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Ivory Coast">Ivory Coast</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="Korea, South">Korea, South</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Laos">Laos</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia, Republic of">Macedonia, Republic of</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia">Micronesia</option><option value="Moldova">Moldova</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro" selected="selected">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="Netherlands Antilles">Netherlands Antilles</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palestinian Territory">Palestinian Territory</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn Island">Pitcairn Island</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Qatar">Qatar</option><option value="Réunion">Réunion</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Helena">Saint Helena</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="São Tome and Principe">São Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leon">Sierra Leon</option><option value="Singapore">Singapore</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="South Africa">South Africa</option><option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="Suriname">Suriname</option><option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option><option value="Swaziland">Swaziland</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="United States">United States</option><option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option><option value="Uruguay">Uruguay</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City">Vatican City</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="Virgin Islands, British">Virgin Islands, British</option><option value="Wallis and Futuna">Wallis and Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option>                                </select>
                            </div>
                        </div>
                    </div>

                </div>

                <div style="clear:both"></div>

                <div class="inner_prices">

                    <div class="control-group last">
                        <label class="control-label" for="service"><?= lang('note') ?>:</label>

                        <div class="controls">
                            <textarea name="notice" id="notice">-notice</textarea>
                        </div>
                    </div>
                </div>

            </div>
            <!-- /passenger-->

            <div id="payment_method" class="secp clearfix">

                <div class="half pull-left">

                    <h4><?= lang('c.methods_of_payment'); ?></h4>

                    <div class="inner_prices">

                        <ul>
                            <li class="clearfix">
                                <input type="radio" name="payment_method" value="Credit card online" checked><?= lang('c.cc_online'); ?>
                            </li>

                        </ul>
                    </div>
                </div>

                <div class="half pull-left">

                    <h4><?= lang('foot.payment'); ?></h4>

                    <div class="inner_prices" style="padding-right: 0">

                        <ul>
                            <li class="clearfix">
                                <input type="radio" name="payment_options" value="Payment in full" checked><?= lang('c.payment_in_full'); ?>
                            </li>

                        </ul>
                    </div>
                </div>

            </div>
            <!-- /payment_method-->

            <div class="secp clearfix">

                <h4 class="mb13">Pickup location</h4>

                <div class="inner_prices">

                    <div class="control-group">
                        <label class="control-label">Pickup location:*</label>
                        <div class="controls">
                            <select name="pickup_location" id="pickup_location" required>
                                <option value="">Pickup location</option>
                                <?php foreach ($pickup_loc as $pickup) : ?>
                                        <option value="<?= $pickup ?>"><?= $pickup ?></option>
                                    <?php endforeach; ?>
                            </select>
                        </div>

                    </div>
                </div>

            </div>
            <!-- /Pickup location-->

            <div id="terms" class="secp clearfix">

                <input type="checkbox" id="agree" name="agree" checked="checked">
                <?= lang('c.i_have_read'); ?>
                <a href="<?= lang_url('cipatravel/termss-37') ?>"><?= lang('c.general_terms'); ?>
                    <? if ($this->lang->mci_current() != 'me') echo '&'; ?>
                    <?= lang('c.conditions'); ?></a>
                <span class="emp">*</span>

            </div>
            <!-- /terms-->

        </div>

        <div class="hold_booknow">
            <input type="submit" class="booknow" value="<?= lang('make_reservation'); ?>">
        </div>
        <!-- /booknow-->

    </form>

</div>